How To Use CPT Code 70100

CPT 70100 describes a radiologic examination of the mandible, specifically a partial examination with less than four views. This article will cover the description, official details, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 70100?

CPT 70100 is used to describe a radiologic examination of the mandible, focusing on a partial examination with less than four views. This code is used when a healthcare provider takes plain X-rays of the lower jaw bone to diagnose fractures or other abnormalities. The number of views obtained may vary depending on the specific diagnostic needs of the patient.

2. Official Description

The official description of CPT code 70100 is: ‘Radiologic examination, mandible; partial, less than four views.’

3. Procedure

1. The healthcare provider performs a radiologic examination of the mandible.
2. Plain X-rays of the lower jaw bone are taken from different angles or projections.
3. The provider obtains one, two, or three views of the mandible, depending on the diagnostic requirements.
4. The X-ray images are analyzed to diagnose fractures or other abnormalities in the mandible.

4. Qualifying circumstances

CPT 70100 is used for patients who require a radiologic examination of the mandible. This may include individuals who have experienced trauma or have symptoms suggestive of a mandible fracture. The examination is performed by a healthcare provider who is qualified to interpret X-ray images and diagnose mandible abnormalities.

5. When to use CPT code 70100

CPT code 70100 should be used when a healthcare provider performs a radiologic examination of the mandible with less than four views. This code is appropriate when the provider obtains one, two, or three views of the mandible to diagnose fractures or other abnormalities. If the provider obtains four or more views, a different code should be used.

6. Documentation requirements

To support a claim for CPT 70100, the healthcare provider must document the following information:

• Reason for the radiologic examination of the mandible
• Number and type of views obtained
• Date of the examination
• Interpretation of the X-ray images and diagnosis
• Signature of the healthcare provider performing the examination

7. Billing guidelines

When billing for CPT 70100, ensure that the radiologic examination of the mandible meets the criteria for a partial examination with less than four views. It is important to accurately document the number of views obtained to avoid billing errors. Additionally, be aware of any bundling or coding edits that may affect the reporting of CPT 70100 with other codes.

8. Historical information

CPT 70100 was added to the Current Procedural Terminology system on January 1, 1990. On January 1, 2009, the code description was changed to specify ‘less than four views’ instead of ‘less than 4 views.’

9. Examples

1. A patient presents with facial trauma, and the healthcare provider performs a radiologic examination of the mandible, obtaining two views to assess for fractures.
2. A patient complains of jaw pain, and the healthcare provider orders a radiologic examination of the mandible, obtaining three views to evaluate for any abnormalities.
3. A patient with a history of mandible fracture undergoes a follow-up radiologic examination, and the healthcare provider obtains one view to assess the healing progress.
4. A patient reports difficulty in opening their mouth, and the healthcare provider performs a radiologic examination of the mandible, obtaining two views to investigate potential causes.
5. A patient presents with swelling and tenderness in the jaw area, and the healthcare provider orders a radiologic examination of the mandible, obtaining three views to identify any underlying issues.